Extended use of aspirin may be an effective, safe, convenient, and inexpensive alternative to low-molecular-weight heparin for preventing venous thromboembolism (VTE), a common complication after total hip replacement.
Using low-molecular-weight heparin for 30 days after hip replacement has been shown to reduce the rate of VTE, but it is expensive and is associated with bleeding after surgery.
Researchers sought to determine if using aspirin after initial treatment with low-molecular-weight heparin would be an effective alternative to extension of low-molecular-weight heparin. After an initial 10 days of dalteparin prophylaxis following elective hip replacement, 778 patients were randomly assigned to 28 days of dalteparin (n=400) or aspirin (n=386).
After 28 days, five patients in the dalteparin group and one patient in the aspirin group had a VTE event, suggesting that aspirin is noninferior, but not superior to dalteparin for the prevention of VTE. The data also suggest that aspirin may cause less bleeding than dalteparin.